Modulation of Pericyte Proliferation

ABSTRACT

Methods and materials for modulating pericyte and epithelial cell proliferation relating to BPI protein products or inhibitors thereof are provided.

This application claims benefit under 35 USC § 119(e) of U.S.provisional application Ser. No. 60/250,542, filed Dec. 1, 2000.

FIELD OF THE INVENTION

The present invention relates generally to novel therapeutic usesassociated with the modulation of perivascular cell proliferation,including the use of BPI protein products, such as BPI-derived peptides,to enhance desirable pericyte proliferation. The present inventionadditionally relates to the use of inhibitors of BPI proteinproduct-induced pericyte proliferation to inhibit deleterious pericyteproliferation. BACKGROUND OF THE INVENTION

Microvascular perivascular cells (“pericytes”) are defined by theirlocation in vivo. The pericyte is a small ovoid shaped cell with manyfinger-like projections that parallel the capillary axis and partiallysurround an endothelial cell in a microvessel. Pericytes share a commonbasement membrane with the endothelial cell. They are elongated cellswith the power of contraction that have been observed to have a varietyof functional characteristics. Pericytes are widely distributed in thebody and include mesangial cells (in the glomeruli of the kidney),Rouget cells, or mural cells (in the retina of the eye) [Hirschi &D'Amore, Cardiovasc Res 1996 Oct;32(4):687-98.]. Some of the pericytefunctional characteristics observed in vivo and in vitro are that theyregulate endothelial cell proliferation and differentiation, contract ina manner that either exacerbates or reduces endothelial cell junctionalinflammatory leakage, synthesize and secrete a wide variety ofvasoactive autoregulating agonists, and synthesize and releasestructural constituents of the basement membrane and extracellularmatrix. [Shepro et al, FASEB J 1993 Aug;7(11):1031-8.] Pericytes havethus been implicated as playing a role in vasoconstriction as well as arole in capillary blood flow, in the formation of blood vessels, in theimmune response (particularly in the central nervous system), and in theextrinsic coagulation pathway. In the kidney, the contractile propertiesof the mesangial cells and their synthesis of various factors andstructural proteins help to regulate the function of the glomerulus.[Schlandoiff, 1987, FASEB J, 1:272-81.]

Pericytes have been suggested to be derived from undifferentiatedmesenchymal cells that are recruited by primordial endothelium and thendifferentiate into pericytes in microvessels or smooth muscle cells inlarge vessels. Pericytes are also pluripotential progenitor cells andhave been shown to differentiate into a variety of different cell types,including osteoblasts, chondrocytes, adipocytes, phagocytes,fibroblasts, and smooth muscle cells. [Sims, 2000, Clin. Exp. Ped.Physiol., 27:842-846.] Pericytes behave in a manner similar toosteoblasts in vitro, by forming a mineralized extracellular matrix andexpressing a number of genes that are also expressed by osteoblasts.These cells also form a well-defined matrix of bone, cartilage, andfibrous tissue in vivo. [Doherty and Canfield, Crit Rev Eukaryot GeneExpr 9(1):1-17, 1999; Hirschi et al., Cardiovasc Res Oct;32(4):687-98,1996.]

The pericyte has been implicated in a variety of pathologies includinghypertension, atherosclerosis, complications of diabetes (bothinsulin-dependent and non-insulin-dependent), ovarian failure, multiplesclerosis, and tumor vascularization, as well as in normal aging.

Microvessels of spontaneously hypertensive rat brains have been shown tohave a relatively higher number of pericytes and an increased ratio ofpericytes to endothelial cells, numbers which increased following theonset of chronic hypertension in the rats. Pericyte contraction has beensuggested to play a pivotal role in regulating the flow of blood withinthe brain microcirculation and perhaps in the etiology and inception ofcerebrovascular disease. [Herman IM et al., Tissue Cell1987;19(2):197-206.]

Pericytes have been identified in the inner intima, the outer media, andin the vasa vasora of the adventitia of large, medium and small humanarteries. Recent studies have suggested that pericytes in the arteriesmay be responsible, at least in part, for mediating the vascularcalcification commonly associated with atherosclerosis [Canfield et al.,Z Kardiol 2000;89 Suppl 2:20-7.] Myxomatous tissue is a characteristiccomponent of human coronary artery lesions and is found more often inrestenotic lesions. This tissue represents a bulky accumulation ofstellate-shaped cells of unknown histogenesis that are embedded in aloose stroma and may be involved in an immune response. Stellate cellsrepresented a heterogenous population, sharing features of smooth musclecells (SMCs), macrophages, as well as antigen-presenting dendriticcells. Some workers have concluded that stellate cells of myxomatoustissue represent a specific phenotype of mesenchymal cells, possiblypericytes, which is activated to express some markers ofantigen-presenting cells. [Tjurmin et al., Arterioscler Thromb Vasc Biol1999 Jan;19(1):83-97.]

In diabetes mellitus, pericytes may be involved in the development ofangiopathy, retinopathy, polyneuropathy and nephropathy. Hyperglycemiamay promote apoptosis and a loss of retinal capillary pericytes veryearly in the development of diabetic retinopathy [Ruggiero et al., 1997Diabetes Metabolism 23:30-42; Hirschi & D'Amore, Cardiovasc Res 1996Oct;32(4):687-98.]. It has been suggested that the sensitivity ofretinal pericytes to degeneration in diabetes is due to their lesserability to reproliferate (compared to, e.g., brain pericytes) inresponse to the metabolic injury of diabetes. [Wong et al. Diabetologia1992 Sep;35(9):818-27.] There is also a difference inpericyte/endothelial cell ratio in the eye (one pericyte per endothelialcell) relative to other locations (neural 1:2, peripheral 1:20) [Speiseret al., 1968 Arch Ophthalmol 80:332-337; Orlidge and D'Amore, 1987, JCell Biol. 105:1455-1462; Sims et al., 1994 Anat Histol Embryol23:232-238.]. Pericyte degeneration has also been observed to precededevelopment of diabetic polyneuropathy and is associated with itsseverity. [Giannini et al., Ann Neurol 1995 Apr;37(4):498-504.]Pericytes have been implicated in the thickening of the glomerularcapillary basement membrane observed in diabetic retinopathy. [Keys etal., 2000, FASEB J, 14:439-47.] During diabetes, mesangial cells showincreased synthesis of various extracellular matrix (ECM) components.This increased synthesis of ECM is also accompanied by a decreaseddegradation of ECM. The major enzymes responsible for ECM degradationare a large group of enzymes collectively known as matrixmetalloproteinases (MMPs). The mesangial cell and its pericellularmatrix have a very active plasminogen cascade that can liberate plasminlocally to mediate matrix degradation both directly and indirectly, byactivating the MMPs. Thus, it is possible that degeneration of mesangialcells mediates the decrease in ECM degradation seen in diabeticnephropathy [McLennan et al., Cell Mol Biol (Noisy-le-grant) 1999Feb;45(1):123-35.]

Pericyte degeneration has also been observed in animal models of ovarianfailure. Ovaries of adult female rats treated with testosteronepropionate and anovulatory ovaries of middle-aged female rats bothexhibited regression of vascular pericytes, T-cells and dendritic cellswithin the interstitial glands. It appears that the function of ovariansteroidogenic cells may be regulated by mesenchymal cells. [Bukovskya etal, Steroids 2000 Apr;65(4):190-205.]

Changes in pericyte population have also been observed during aging.There appears to be regional variation in the age-associated changes inthe brain microvasculature. In the frontal cortex and hippocampus, thereappears to be an increase in basement membrane with increasing age,accompanied by increased pericyte mitochondrial size. In the frontalcortex, there is increased capillary lumen area but in the hippocampusthere is decreased capillary lumen area in the hippocampus. [Hicks P,Neurobiol Aging 1983 Spring;4(1):69-75.] The brains of aging rats havebeen found to have increased astrocyte and pericyte populations in theparietal cortex. [Peinado MA et al., Microsc Res Tech 1998 Oct1:43(1):34-42.] At the ultrastructural level different anomalies of thecerebral microvasculature are encountered. These aberrations can eitherbe attributed to degeneration processes or to the perivasculardeposition of, e.g., collagen fibrils and other proteinaceous debris.[de Jong Neurobiol. Aging 1992 Jan-Feb; 13(1):73-81.]

Of interest is the disclosure in Hu et al., Br. J. Exp. Pathol. 1989Apr; 70(2): 113-24 that intermittent treatment of mice with heparin hasbeen shown to reduce the right ventricular hypertrophy caused byhypoxia; administration of heparin reduced the proportion of arteriesthat became muscularized, particularly at the alveolar duct level wherethe pericyte is the precursor smooth muscle cell. See also Khoury etal., Am. J. Physiol. Lung Cell Mol. Physiol., 279:L252-L261, 2000, areport that heparin-like molecules inhibit pulmonary vascular pericyteproliferation in vitro.

Thus, there exists a need for an agents that modulate pericyteproliferation. In conditions where proliferation of pericytes isdesirable, there is a need for agents that allow or enhance suchproliferation to be enhanced. In conditions where proliferation ofpericytes is deleterious, there is a need for agents that inhibit suchproliferation.

BPI is a protein isolated from the granules of mammalianpolymorphonuclear leukocytes (PMNs or neutrophils), which are bloodcells essential in the defense against invading microorganisms. HumanBPI protein has been isolated from PMNs by acid extraction combined witheither ion exchange chromatography [Elsbach, J. Biol. Chem., 254:11000(1979)] or E. coli affinity chromatography [Weiss, et al., Blood, 69:652(1987)]. BPI obtained in such a manner is referred to herein as naturalBPI and has been shown to have potent bactericidal activity against abroad spectrum of gram-negative bacteria. The molecular weight of humanBPI is approximately 55,000 daltons (55 kD). The amino acid sequence ofthe entire human BPI protein and the nucleic acid sequence of DNAencoding the protein have been reported in U.S. Pat. No. 5,198,541 andFIG. 1 of Gray et al., J. Biol. Chem., 264:9505 (1989), incorporatedherein by reference. The Gray et al. nucleic acid and amino acidsequence are set out in SEQ ID NOS: 1 and 2 hereto. U.S. Pat. No.5,198,541 discloses recombinant genes encoding and methods forexpression of BPI proteins, including BPI holoprotein and fragments ofBPI. Recombinant human BPI holoprotein has also been produced in whichvaline at position 151 is specified by GTG rather than GTC, residue 185is glutamic acid (specified by GAG) rather than lysine (specified byAAG) and residue 417 is alanine (specified by GCT) rather than valine(specified by GTT). BPI is a strongly cationic protein. The N-terminalhalf of BPI accounts for the high net positive charge; the C-terminalhalf of the molecule has a net charge of −3. [Elsbach and Weiss (1981),supra.] A proteolytic N-terminal fragment of BPI having a molecularweight of about 25 kD possesses essentially all the anti-bacterialefficacy of the naturally-derived 55 kD human BPI holoprotein. [Ooi etal., J. Bio. Chem., 262: 14891-14894 (1987)]. In contrast to theN-terminal portion, the C-terminal region of the isolated human BPIprotein displays only slightly detectable anti-bacterial activityagainst gram-negative organisms. [Ooi et al., J. Exp. Med., 174:649(1991).] An N-terminal BPI fragment of approximately 23 kD, referred toas “rBPI₂₃,” has been produced by recombinant means and also retainsanti-bacterial activity against gram-negative organisms.[Gazzano-Santoro et al., Infect. Immun. 60:4754-4761 (1992).] AnN-terminal analog designated rBPI₂₁ (also referred to asrBPI(1-193)ala¹³²) has been described in U.S. Pat. No. 5,420,019.

The bactericidal effect of BPI was originally reported to be highlyspecific to gram-negative species, e.g., in Elsbach and Weiss,Inflammation: Basic Principles and Clinical Correlates, eds. Gallin etal., Chapter 30, Raven Press, Ltd. (1992). The precise mechanism bywhich BPI kills gram-negative bacteria is not yet completely elucidated,but it is believed that BPI must first bind to the surface of thebacteria through electrostatic and hydrophobic interactions between thecationic BPI protein and negatively charged sites on LPS. In susceptiblegram-negative bacteria, BPI binding is thought to disrupt LPS structure,leading to activation of bacterial enzymes that degrade phospholipidsand peptidoglycans, altering the permeability of the cell's outermembrane, and initiating events that ultimately lead to cell death.[Elsbach and Weiss (1992), supra]. LPS has been referred to as“endotoxin” because of the potent inflammatory response that itstimulates, i.e., the release of mediators by host inflammatory cellswhich may ultimately result in irreversible endotoxic shock. BPI bindsto lipid A, reported to be the most toxic and most biologically activecomponent of LPS.

BPI protein products have a wide variety of beneficial activities. BPIprotein products are bactericidal for gram-negative bacteria, asdescribed in U.S. Pat. Nos. 5,198,541, 5,641,874, 5,948,408, 5,980,897and 5,523,288. International Publication No. WO 94/20130 proposesmethods for treating subjects suffering from an infection (e.g.gastrointestinal) with a species from the gram-negative bacterial genusHelicobacter with BPI protein products. BPI protein products alsoenhance the effectiveness of antibiotic therapy in gram-negativebacterial infections, as described in U.S. Pat. Nos. 5,948,408,5,980,897 and 5,523,288 and International Publication Nos. WO 89/01486(PCT/US99/02700) and WO 95/08344 (PCT/US94/11255). BPI protein productsare also bactericidal for gram-positive bacteria and mycoplasma, andenhance the effectiveness of antibiotics in gram-positive bacterialinfections, as described in U.S. Pat. Nos. 5,578,572 and 5,783,561 andInternational Publication No. WO 95/19180 (PCT/US95/00656). BPI proteinproducts exhibit antifungal activity, and enhance the activity of otherantifungal agents, as described in U.S. Pat. No. 5,627,153 andInternational Publication No. WO 95/19179 (PCT/US95/00498), and furtheras described for BPI-derived peptides in U.S. Pat. No. 5,858,974, whichis in turn a continuation-in-part of U.S. application Ser. No.08/504,841 and corresponding International Publication Nos. WO 96/08509(PCT/US95/09262) and WO 97/04008 (PCT/US96/03845), as well as in U.S.Pat. Nos. 5,733,872, 5,763,567, 5,652,332, 5,856,438 and correspondingInternational Publication Nos. WO 94/20532 (PCT/US/94/02465) and WO95/19372 (PCT/US94/10427). BPI protein products exhibit anti-protozoanactivity, as described in U.S. Pat. Nos. 5,646,114 and 6,013,629 andInternational Publication No. WO 96/01647 (PCT/US95/08624). BPI proteinproducts exhibit anti-chlamydial activity, as described in co-owned U.S.Pat. No. 5,888,973 and WO 98/06415 (PCT/US97/13810). Finally, BPIprotein products exhibit anti-mycobacterial activity, as described inco-owned, co-pending U.S. application Ser. No. 08/626,646, which is inturn a continuation of U.S. application Ser. No. 08/285,803, which is inturn a continuation-in-part of U.S. application Ser. No. 08/031,145 andcorresponding International Publication No. WO 94/20129(PCT/US94/02463).

The effects of BPI protein products in humans with endotoxin incirculation, including effects on TNF, IL-6 and endotoxin are describedin U.S. Pat. Nos. 5,643,875, 5,753,620 and 5,952,302 and correspondingInternational Publication No. WO 95/19784 (PCT/US95/01151).

BPI protein products are also useful for treatment of specific diseaseconditions, such as meningococcemia in humans (as described in U.S. Pat.Nos. 5,888,977 and 5,990,086 and International Publication No. WO97/42966 (PCT/US97/08016), hemorrhage due to trauma in humans, (asdescribed in U.S. Pat. Nos. 5,756,464 and 5,945,399, U.S. applicationSer. No. 08/862,785 and corresponding International Publication No. WO97/44056 (PCT/US97/08941), burn injury (as described in U.S. Pat. No.5,494,896 and corresponding International Publication No. WO 96/30037(PCT/US96/02349)) ischemia/reperfusion injury (as described in U.S. Pat.No. 5,578,568), and depressed RES/liver resection (as described inco-owned, co-pending U.S. application Ser. No. 08/582,230 which is inturn a continuation of U.S. application Ser. No. 08/318,357, which is inturn a continuation-in-part of U.S. application Ser. No. 08/132,510, andcorresponding International Publication No. WO 95/10297(PCT/US94/11404).

BPI protein products also neutralize the anticoagulant activity ofexogenous heparin, as described in U.S. Pat. No. 5,348,942, neutralizeheparin in vitro as described in U.S. Pat. No. 5,854,214, and are usefulfor treating chronic inflammatory diseases such as rheumatoid andreactive arthritis, for inhibiting endothelial cell proliferation, andfor inhibiting angiogenesis and for treating angiogenesis-associateddisorders including malignant tumors, ocular retinopathy andendometriosis, as described in U.S. Pat. Nos. 5,639,727, 5,807,818 and5,837,678 and International Publication No. WO 94/20128(PCT/US94/02401).

BPI protein products are also useful in antithrombotic methods, asdescribed in U.S. Pat. Nos. 5,741,779 and 5,935,930 and correspondingInternational Publication No. WO 97/42967 (PCT/US7/08017).

SUMMARY OF THE INVENTION

The present invention provides novel therapeutic methods of modulatingproliferation of pericytes, including mural cells of the retina andmesangial cells of the kidney. In conditions where pericyteproliferation is desirable, the invention provides methods of using atherapeutically effective amount of a BPI protein product to enhancepericyte proliferation. Such conditions include complications ofdiabetes (both insulin-dependent and non-insulin-dependent), otherdiseases associated with the presence of autoantibodies to pericytes,age-related macular degeneration (ARMD), ovarian failure, multiplesclerosis, Alzheimer' s disease, traumatic brain injury or otherconditions involving perturbation of the blood-brain-barrier, partialseizures and placental development in pregnancy. In particular, sequelaeof diabetes mellitus include diabetic retinopathy, diabeticpolyneuropathy, diabetic nephropathy, skeletal muscle degeneration afterpericyte degeneration, or other organ complications.

In conditions where pericyte proliferation is deleterious, the inventionprovides methods of inhibiting pericyte proliferation usingtherapeutically effective amounts of inhibitors capable of inhibitingthe type of proliferation induced by BPI protein product, e.g.,antibodies or other agents capable of binding to BPI protein product orotherwise inhibiting interaction with its receptor or ligand, orantagonists of the pericyte receptor that recognizes BPI proteinproducts. Such conditions include hypertension, vascular disease,atherosclerosis, including formation of vascular calcifications andatherosclerotic plaques, restenosis, acute respiratory distress syndrome(ARDS), endometriosis or adenomyosis, and normal aging. In particular,sequelae of hypertension, atherosclerosis and other vascular diseasesinclude cerebrovascular ischemia or stroke, coronary artery disease andmyocardial ischemia or infarction, peripheral vascular disease,Raynaud's syndrome, early occlusion of peripheral arteries or vascularremodeling associated with pulmonary hypertension.

Uses of BPI protein products according to the invention are specificallycontemplated in mammals, particularly humans, for prophylactic ortherapeutic treatment of disease states or conditions mediated orexacerbated by pericyte proliferation or degeneration.

Studies suggest that undifferentiated mesenchymal cells or fibroblaststransform into capillary pericytes which in turn transform into vascularsmooth muscle and other related cells such as adipocytes, osteoblastsand phagocytes [Rhodin & Fujita 1989 Submicrosc Cytol Pathol 21:1-34;Doherty & Canfield 1999 Crit Rev Euk Gene Exp 9(1):1-17]. Thus, furtherprovided are methods for enhancing the production or formation ofosteoblasts, chondrocytes, adipocytes, phagocytes, fibroblasts, andsmooth muscle cells from pericytes and thus repairing or replacingdamaged tissue, e.g. in wounds. In addition to enhancing proliferationof such cells per se, BPI protein products, including BPI-derivedpeptides, may be expected to enhance differentiation of pericytes intocertain cell types, or to enhance proliferation of the finallydifferentiated cell types. Such methods are expected to be useful in avariety of conditions including enhancing wound healing, treatment ofbone fractures or bone degenerative disorders.

Exemplary BPI protein products include recombinantly-produced N-terminalanalogs or fragments of BPI, especially those having a molecular weightof approximately between 20 to 25 kD such as rBPI₂₁, rBPI₂₃,rBPI(10-193)C132A (also designated rBPI(10-193)ala¹³²), dimeric forms ofthese N-terminal polypeptides (e.g., rBPI₄₂ dimer), or BPI-derivedpeptides. Exemplary BPI-derived peptides include peptides derived fromBPI domain II, such as XMP.679 ([SEQ ID NO: 3]), the structure andactivity of which are described in co-owned U.S. Ser. No. 09/602,811filed Jun. 23, 2000, which is a continuation-in-part of U.S. Ser. No.09/344,219 filed Jun. 25, 1999, each incorporated herein by reference.

It is contemplated that the administration of a BPI protein product maybe accompanied by the concurrent administration of other therapeuticagents, such as growth factors that enhance proliferation of pericytesor inhibitors of such growth factors, depending on the condition.

The invention also provides methods of screening for other BPI proteinproducts that enhance pericyte proliferation. Such methods wouldcomprise steps of, e.g., detecting or measuring growth or proliferationof pericytes in the presence and optionally the absence of a BPI proteinproduct. Optionally the screening methods involve a further step oftesting selected candidate compounds in animal models of pericyteproliferation wherein the proliferation results in desirable effects.The screening methods may also involve a further step of testingselected candidate compounds for ability to inhibit endothelial cellproliferation or angiogenesis (vasculogenesis). BPI protein products,including BPI-derived peptides, can be screened forproliferation-promoting activity using these methods. In addition, therational design of molecules that function like pericyteproliferation-enhancing BPI protein products is contemplated. Forexample, peptides or other organic molecules may be synthesized thatmimic the structure and function of BPI protein products with thedesired pericyte proliferation-enhancing activity.

The invention also provides methods of screening for a candidateenhancer of pericyte proliferation including (a) measuring proliferationof pericytes in the presence and absence of a test compound, (b)measuring proliferation in the presence of the test compound and a BPIprotein product (preferably at a concentration effective to enhancepericyte proliferation), and identifying the test compound as acandidate enhancer of pericyte proliferation when pericyte proliferationis increased in step (a) but not further increased in step (b), or whenthe increase in pericyte proliferation measured in step (a) is about thesame as or less than the increase in pericyte proliferation measured instep (b).

The invention further provides methods of screening organic or inorganiccompounds for the ability to inhibit proliferation induced by BPIprotein products. Suitable standards for use in such screening assaysinclude any BPI protein product that enhances pericyte proliferation,e.g., rBPI₂₁ or XMP.679. Such methods would comprise steps of, e.g.,contacting pericytes with a BPI protein product and a candidatecompound, and detecting or measuring growth or proliferation of thecells in the presence and absence of the test compound. A test compoundis identified as a candidate inhibitor of BPI-induced proliferation whenproliferation of the pericytes induced by the BPI protein product isreduced in the presence of the test compound. Optionally, as a control,the growth or proliferation of the pericytes is also measured in thepresence and absence of the test compound alone (in the absence of BPIprotein product). The screening methods may involve a further step oftesting selected candidate compounds in animal models of pericyteproliferation wherein the proliferation results in deleterious effects.These methods according to the invention can be used for high throughputscreening of libraries of molecules, such as inorganic or organiccompounds (including bacterial, fungal, mammalian, insect or plantproducts, peptides, peptidomimetics and/or organomimetics).

Further provided are compounds identified by the screening methodsdescribed herein as well as methods of treatment using these compounds,to modulate (i.e., allow or enhance or inhibit) pericyte proliferation.

Yet another aspect of the invention provides methods for enhancingepithelial cell proliferation, particularly in the retina, byadministering an effective amount of a BPI protein product, and methodsfor screening for compounds, either BPI protein products, BPI proteinproduct mimetics, or small molecules, that allow or enhance epithelialcell proliferation, particularly in the retina (e.g. retinitispigmentosa or choroidal neovascularisation seen in age-related maculardegeneration [Campochiaro et al., Molecular Vision, 1999, 5:34 (1999)]),in wounds or bone fractures. Corresponding use of BPI protein productsin preparation of a medicament for the treatment of diseases involvingepithelial cell degeneration or diseases that would benefit fromepithelial cell (particularly retinal epithelial cell) proliferation isalso contemplated. In addition, this aspect of the invention includescorresponding methods of screening for other BPI protein products forthe ability to enhance epithelial cell proliferation, particularlyretinal epithelial cell proliferation, and methods of screening organicor inorganic compounds for the ability to inhibit epithelial cellproliferation induced by BPI protein products.

Numerous additional aspects and advantages of the invention will becomeapparent to those skilled in the art upon consideration of the followingdetailed description of the invention which describes presentlypreferred embodiments thereof.

BRIEF DESCRIPTION OF THE DRAWINGS

FIGS. 1A-1B display effects of BPI protein products on bovine retinalpericyte proliferation.

FIG. 2 displays effects of BPI protein products on bovine retinalepithelial cell proliferation.

DETAILED DESCRIPTION OF THE INVENTION

Pericytes are found throughout the body surrounding endothelial cells inmicrovessels, including in the skin, retina, cochlea (auditoryapparatus), brain, heart, muscle, kidney, placenta, liver, lung, spleenand bone marrow include the mural cells of the retina, the mesangialcells of the kidney glomerulus, the Ito cells of the liver, and thereticular cells of the spleen and bone marrow. The present inventionprovides novel therapeutic uses and screening methods involvingmodulation of pericyte proliferation systemically or locally. Theinvention is based on the unexpected finding that BPI protein products,including rBPI₂₁ and BPI-derived peptides, stimulate proliferation ofpericytes. In contrast to the anti-angiogenic, anti-inflammatory,anti-microbial and other properties of BPI protein products, which havebeen described in a number of different co-owned patents andapplications, including those described hereinabove or below, thepresent invention with respect to use of BPI protein products is basedon the modulation of pericyte-mediated effects.

The invention contemplates methods for treating disease states orconditions associated with, resulting from or exacerbated by pericytedegeneration, by administration of an amount of a BPI protein producteffective to enhance pericyte proliferation. In this method,co-administration of other growth factors that enhance pericyteproliferation is also contemplated. Degeneration of pericytes isbelieved to be involved in the pathogenesis of complications of diabetes(both insulin-dependent and non-insulin-dependent), other diseasesassociated with the presence of autoantibodies to pericytes [Attawia etal., Retina, 1999; 19(5):390-400 report that diabetic subjects have beenfound to have autoantibodies to microvascular pericytes in theircirculation], age-related macular degeneration (ARMD) [Monaco &Wormington Optim Vis Sci 1990 Jul;67(7):532-7; Hope et al., Br JOphthalmol. 1992 Jan;76(1):11-16], ovarian failure, multiple sclerosis[Verbeck et al., J. Immunol., 154:5876-84 (1995)], Alzheimer's disease[Verbeek et al., 1997, J. Neurochem, 68:1135, Verbeek et al., 1999,Cell. Mol. Biol., 45:37-46; Farkas et al., Acta Neuropathol (Berl) 2000Oct;100(4):395-402], traumatic brain injury or other conditionsinvolving perturbation of the blood-brain-barrier [Dore-Duffy et al.,Microvasc. Res., 2000, 60(1):55-69], partial seizures [Liwnicz et al.,1990 Neurosurg. 26 (3):409-420], and placental development in pregnancy[Ohlsson et al., Dev. Biol. 1999:212(1):124-36; Challier et al., CellMol. Biol. 1999, 45(1):89-100]. Enhancing proliferation of pericytes oreven merely ameliorating the degree of degeneration of pericytes thusmay prevent or reduce onset and severity of these disorders and theirsequelae. In particular, sequelae of diabetes mellitus include diabeticretinopathy, diabetic polyneuropathy, diabetic nephropathy, skeletalmuscle degeneration after pericyte degeneration, or other organcomplications.

Endotoxin is a potent pulmonary pericyte mitogen; in sepsis, pericytesmay be involved in post-sepsis tissue remodeling. [Sims, 2000, Clin.Exp. Ped. Physiol., 27:842; Khoury et al., Microvasc. Res., 1998,56:71-84.]

Pericyte degeneration is observed very early in diabetes mellitus,before any of the potential complications of diabetes mellitus areobserved. Reversal of such degeneration via enhancement of pericyteproliferation is thus expected to be beneficial to subjects sufferingfrom diabetes mellitus during the time period before onset ordevelopment of complications, even before the histologic or clinicalchanges of angiopathy or nephropathy have been observed. Earlyhistological changes include thickened retinal cell basement membrane,pericyte degeneration, capillary microaneurysm, and arteriolarhyalinization. As disease progression occurs, increased vascularpermeability and progressive retinal vessel closure results in clinicalmanifestations such as increasing vision loss and retinal necrosis.[Hammer et al., 1991 Proc. Nat'l Acad. Sci. USA, 88:11555.]

The invention also contemplates methods for treating disease states orconditions associated with, resulting from or exacerbated by pericyteproliferation by administration of an amount of a BPI inhibitoreffective to reduce or eliminate pericyte proliferation. Proliferationof pericytes is believed to play a role in hypertension, vasculardisease, atherosclerosis, including formation of vascular calcificationsand atherosclerotic plaques, restenosis, acute respiratory distresssyndrome (ARDS) [Kim et al., 1998, Hypertension, 31:511-515],endometriosis or adenomyosis [Mai et al., Histopathology1997;30(5):430-42], and normal aging [Hicks et al., 1983, Neurobiol.Aging 4(1):69-75]. Reducing or even entirely preventing proliferation ofpericytes thus may prevent or reduce onset or severity of thesediseases, disorders associated with them, or their sequelae. Inparticular, sequelae of hypertension, atherosclerosis and other vasculardiseases include cerebrovascular ischemia or stroke, coronary arterydisease and myocardial ischemia or infarction, peripheral vasculardisease, Raynaud's syndrome, early occlusion of peripheral arteries orvascular remodeling associated with pulmonary hypertension [Khoury etal., 2000, Am. J. Physiol. Lung Cell. Mol. Physiol., 279(2):L252-L261.]

Further provided by the invention are methods for enhancing theproduction or formation or proliferation of osteoblasts, chondrocytes,adipocytes, phagocytes, fibroblasts, and smooth muscle cells frompericytes [Schor et al., 1995, Clin. Orthoped. Rel. Res., 313:81-91;Sims, 2000, Clin. Exp. Ped. Physiol., 27:842-846] and thus repairing orreplacing damaged tissue. Enhancing the formation or proliferation ofosteoblasts or chondrocytes is expected to be beneficial in conditionsassociated with bone or cartilage loss or degeneration, referred toherein as a “bone degenerative disorder,” including osteoporosis,osteonecrosis, osteomalacia, rickets, rheumatoid arthritis [Doherty etal., 1998, J. Bone Min. Res., 13:828-838], osteoarthritis, bonefractures, bone grafts, surgical loss of bone, or tendon or ligamentformation. Formation or proliferation of fibroblasts is expected to bebeneficial in wound healing including burns, incisions, ulcers, skingrafting. Formation or proliferation of phagocytes is expected to bebeneficial in situations involving exposure to infectious agents.

The term “treating” or “treatment” as used herein encompasses bothprophylactic and therapeutic treatment, and may be accompanied byconcurrent administration or co-administration of other therapeuticagents having a desired effect. Treatment of any subject iscontemplated, especially mammalian subjects such as humans, but alsoincluding farm animals such as cows, sheep, pigs, horses, goats orpoultry (e.g., chickens, turkeys, ducks or geese), companion animalssuch as dogs or cats, exotic and/or zoo animals, or laboratory animalsincluding mice, rats, rabbits, guinea pigs, or hamsters.

“Concurrent administration,” or “co-administration,” as used hereinincludes administration of one or more agents, in conjunction, or incombination, together, or before or after each other. The agents may beadministered by the same or by different routes. If administered via thesame route, the agents may be given simultaneously or sequentially, aslong as they are given in a manner sufficient to allow all agents toachieve effective concentrations at the site of action.

Therapeutic compositions may be administered systemically, locally intothe appropriate area, or topically. Systemic routes of administrationinclude oral, intravenous, intramuscular or subcutaneous injection(including into a depot for long-term release), intraocular orretrobulbar, intrathecal, intraperitoneal (e.g. by intraperitoneallavage), intrapulmonary (using powdered drug, or an aerosolized ornebulized drug solution), or transdermal. In some instances, it isadvantageous to administer the BPI protein product regionally or locallyby selective catheterization of an involved vessel or by directinjection into the local area (e.g., into a depot for long-termrelease). It may also be advantageous to administer BPI protein productcovalently or noncovalently linked to a targeting agent, e.g. anantibody specific for a tissue or cell type. Suitable dosages forsystemic or local administration include doses ranging from 1 μg/kg to100 mg/kg per day or doses ranging from 0.1 mg/kg to 20 mg/kg per day.The treatment may be continuous or by intermittent administration, atthe same, reduced or increased dose per day for as long as determined bythe treating physician.

Topical routes include administration in the form of salves, creams,jellies, ophthalmic drops or ointments (as described in co-owned,co-pending U.S. application Ser. No. 08/557,289 and 08/557,287, bothfiled Nov. 14, 1995), ear drops, suppositories, irrigation fluids (for,e.g., irrigation of wounds) or medicated shampoos. For example, fortopical administration in drop form, about 10 to 200 μL of a therapeuticcomposition may be applied one or more times per day as determined bythe treating physician.

Those skilled in the art can readily optimize effective dosages andadministration regimens for therapeutic compositions as determined bygood medical practice and the clinical condition of the individualsubject.

As used herein, “BPI protein product” includes naturally orrecombinantly produced BPI protein; natural, synthetic, or recombinantbiologically active polypeptide fragments of BPI protein; biologicallyactive polypeptide variants of BPI protein or fragments thereof,including hybrid fusion proteins or dimers; biologically activepolypeptide analogs of BPI protein or fragments or variants thereof,including cysteine-substituted analogs; or BPI-derived peptides. The BPIprotein products administered according to this invention may begenerated and/or isolated by any means known in the art. U.S. Pat. Nos.5,198,541 and 5,641,874, the disclosures of which are incorporatedherein by reference, disclose recombinant genes encoding, and methodsfor expression of, BPI proteins including recombinant BPI holoprotein,referred to as rBPI and recombinant fragments of BPI. U.S. Pat. No.5,439,807 and corresponding International Publication No. WO 93/23540(PCT/US93/04752), which are all incorporated herein by reference,disclose novel methods for the purification of recombinant BPI proteinproducts expressed in and secreted from genetically transformedmammalian host cells in culture and discloses how one may produce largequantities of recombinant BPI products suitable for incorporation intostable, homogeneous pharmaceutical preparations.

Biologically active fragments of BPI (BPI fragments) includebiologically active molecules that have the same or similar amino acidsequence as a natural human BPI holoprotein, except that the fragmentmolecule lacks amino-terminal amino acids, internal amino acids, and/orcarboxy-terminal amino acids of the holoprotein, including thosedescribed in U.S. Pat. Nos. 5,198,541 and 5,641,874. Nonlimitingexamples of such fragments include an N-terminal fragment of naturalhuman BPI of approximately 25 kD, described in Ooi et al., J. Exp.Med.,174:649 (1991), or the recombinant expression product of DNAencoding N-terminal amino acids from 1 to about 193 to 199 of naturalhuman BPI, described in Gazzano-Santoro et al., Infect. Immun.60:4754-4761 (1992), and referred to as rBPI₂₃. In that publication, anexpression vector was used as a source of DNA encoding a recombinantexpression product (rBPI₂₃) having the 31-residue signal sequence andthe first 199 amino acids of the N-terminus of the mature human BPI, asset out in FIG. 1 of Gray et al., supra, except that valine at position151 is specified by GTG rather than GTC and residue 185 is glutamic acid(specified by GAG) rather than lysine (specified by AAG). Recombinantholoprotein (rBPI) has also been produced having the sequence (SEQ IDNOS: 1 and 2) set out in FIG. 1 of Gray et al., supra, with theexceptions noted for rBPI₂₃ and with the exception that residue 417 isalanine (specified by GCT) rather than valine (specified by GTT).Another fragment consisting of residues 10-193 of BPI has been describedin U.S. Pat. No. 6,013,631, continuation-in-part U.S. application Ser.No. 09/336,402, filed Jun. 18, 1999, and corresponding InternationalPublication No. WO 99/66044 (PCT/US99/13860), all of which areincorporated herein by reference. Other examples include dimeric formsof BPI fragments, as described in U.S. Pat. Nos. 5,447,913, 5,703,038,and 5,856,302 and corresponding International Publication No. WO95/24209 (PCT/US95/03125), all of which are incorporated herein byreference.

Biologically active variants of BPI (BPI variants) include but are notlimited to recombinant hybrid fusion proteins, comprising BPIholoprotein or biologically active fragment thereof and at least aportion of at least one other polypeptide, or dimeric forms of BPIvariants. Examples of such hybrid fusion proteins and dimeric forms aredescribed in U.S. Pat. No. 5,643,570 and corresponding InternationalPublication No. WO 93/23434 (PCT/US93/04754), which are all incorporatedherein by reference and include hybrid fusion proteins comprising, atthe amino-terminal end, a BPI protein or a biologically active fragmentthereof and, at the carboxy-terminal end, at least one constant domainof an immunoglobulin heavy chain or allelic variant thereof (e.g., aBPI-Ig fusion protein).

Biologically active analogs of BPI (BPI analogs) include but are notlimited to BPI protein products wherein one or more amino acid residueshave been replaced by a different amino acid. For example, U.S. Pat.Nos. 5,420,019, 5,674,834 and 5,827,816 and corresponding InternationalPublication No. WO 94/18323 (PCT/US94/01235), all of which areincorporated herein by reference, discloses polypeptide analogs of BPIand BPI fragments wherein a cysteine residue is replaced by a differentamino acid. A stable BPI protein product described by this applicationis the expression product of DNA encoding from amino acid 1 toapproximately 193 or 199 of the N-terminal amino acids of BPIholoprotein, but wherein the cysteine at residue number 132 issubstituted with alanine and is designated rBPI₂,Acys or rBPI₂₁.Production of this N-terminal analog of BPI, rBPI₂₁, has been describedin Horwitz et al., Protein Expression Purification, 8:28-40 (1996).Similarly, an analog consisting of residues 10-193 of BPI in which thecysteine at position 132 is replaced with an alanine (designated“rBPI(10-193)C132A” or “rBPI(10-193)ala¹³²”) has been described in U.S.Pat. No. 6,013,631, continuation-in-part U.S. application Ser. No.09/336,402, filed Jun. 18, 1999, and corresponding InternationalPublication No. WO 99/66044 (PCT/US99/13860), all of which areincorporated herein by reference. Other examples include dimeric formsof BPI analogs; e.g. U.S. Pat. Nos. 5,447,913, 5,703,038, and 5,856,302and corresponding International Publication No. WO 95/24209(PCT/US95/03125), all of which are incorporated herein by reference.

Other BPI protein products useful according to the methods of theinvention are peptides derived from or based on BPI produced bysynthetic or recombinant means (BPI-derived peptides), such as thosedescribed in International Publication No. WO 97/04008 (PCT/US96/03845),which corresponds to U.S. application Ser. No. 08/621,259 filed Mar. 21,1996, and International Publication No. WO 96/08509 (PCT/US95/09262),which corresponds to U.S. Pat. No. 5,858,974, and InternationalPublication No. WO 95/19372 (PCT/US94/10427), which corresponds to U.S.Pat. Nos. 5,652,332 and 5,856,438, and International Publication No.WO94/20532 (PCT/US94/02465), which corresponds to U.S. Pat. No.5,763,567 which is a continuation of U.S. Pat. No. 5,733,872, which is acontinuation-in-part of U.S. application Ser. No. 08/183,222, filed Jan.14, 1994, which is a continuation-in-part of U.S. application Ser. No.08/093,202 filed Jul. 15, 1993 (corresponding to InternationalPublication No. WO 94/20128 (PCT/US94/02401)), which is acontinuation-in-part of U.S. Pat. No. 5,348,942, as well asInternational Application No. PCT/US97/05287, which corresponds to U.S.Pat. No. 5,851,802, the disclosures of all of which are incorporatedherein by reference. Methods of recombinant peptide production aredescribed in U.S. Pat. No. 5,851,802 and International Publication No.WO 97/35009 (PCT/US97/05287), the disclosures of which are incorporatedherein by reference.

Exemplary BPI protein products include recombinantly-produced N-terminalanalogs or fragments of BPI, especially those having a molecular weightof approximately between 20 to 25 kD such as rBPI₂₁, rBPI₂₃,rBPI(10-193)C132A, (rBPI(10-193)ala¹³²), dimeric forms of theseN-terminal polypeptides (e.g., rBP ₂ dimer), or BPI-derived peptides.Exemplary BPI-derived peptides include peptides derived from domain IIof BPI, such as XMP.679 [the structure and activity of which aredescribed in co-owned U.S. Ser. No. 09/602,811 filed Jun. 23, 2000,which is a continuation-in-part of U.S. Ser. No. 09/344,219 filed Jun.25, 1999, each incorporated herein by reference].

The administration of BPI protein products is preferably accomplishedwith a pharmaceutical composition comprising a BPI protein product and apharmaceutically acceptable diluent, adjuvant, or carrier. The BPIprotein product may be administered without or in conjunction with knownsurfactants or other therapeutic agents. A stable pharmaceuticalcomposition containing BPI protein products (e.g., rBPI₂₃) comprises theBPI protein product at a concentration of 1 mg/ml in citrate bufferedsaline (5 or 20 mM citrate, 150 mM NaCl, pH 5.0) comprising 0.1% byweight of poloxamer 188 (Pluronic F-68, BASF Wyandotte, Parsippany,N.J,) and 0.002% by weight of polysorbate 80 (Tween 80, ICI AmericasInc., Wilmington, Del.). Another stable pharmaceutical compositioncontaining BPI protein products (e.g., rBPI₂₁) comprises the BPI proteinproduct at a concentration of 2 mg/ml in 5 mM citrate, 150 mM NaCl, 0.2%poloxamer 188 and 0.002% polysorbate 80. Such preferred combinations aredescribed in U.S. Pat. Nos. 5,488,034, 5,696,090 and 5,955,427 andcorresponding International Publication No. WO 94/17819(PCT/US94/01239), the disclosures of all of which are incorporatedherein by reference. As described in U.S. Pat. No. 5,912,228 andcorresponding International Publication No. WO96/21436 (PCT/US96/01095),all of which are incorporated herein by reference, other poloxamerformulations of BPI protein products with enhanced activity may beutilized, optionally with EDTA.

Growth factors contemplated according to the methods of the presentinvention include endothelin-1 or platelet-derived growth factor-β(PDGF-β), both of which have been suggested to induce or enhancepericyte proliferation [Yamagishi et al., Biochem Biophys Res Commun1993 Mar 31;191(3):840-6; Hellstrom et al., Development 1999 June;126(14):3047-55], PDGF (or PDGF A chain or AA or AB or B chain or BB)and transforming growth factor-beta (TGF-β) (or TGF-α, -β1, -β1.2, -β2,-β3, -β5, or latent TGF-β1), vascular permability factor/vascularendothelial growth factor (VPF/VEGF), acidic fibroblast growth factor(aFGF), basic fibroblast growth factor (bFGF), FGF-4, -5, -6, -7, -8,-8b, -8c, -9, -10, endothelial cell growth factor (ECGF) or β-ECGF, aswell as known angiopoietins (e.g., Ang-1, Ang-2, Ang-4, or Ang-Y),angiogenin, bone morphogenic proteins (BMPs, e.g., BMP-1, -2, -3, -4,-5, -6, -7, -8, -9, -10, -11, -12, -13, -14 or -15), bone morphogenicprotein receptor IA or IB, brain derived neurotrophic factor (BDNF),ciliary neutrophic factor (CNF), ciliary neutrophic factor receptor α,cytokine-induced neutrophil chemotactic factor 1, cytokine-inducedneutrophil, chemotactic factor 2 α, cytokine-induced neutrophilchemotactic factor 2 β, epidermal growth factor, epithelial-derivedneutrophil attractant, glial cell line-derived neutrophic factorreceptor α1, glial cell line-derived neutrophic factor receptor α 2,growth related protein, growth related protein a, growth related proteinβ, growth related protein γ, heparin binding epidermal growth factor,hepatocyte growth factor, hepatocyte growth factor receptor,insulin-like growth factor I, insulin-like growth factor receptor,insulin-like growth factor II, insulin-like growth factor bindingprotein, keratinocyte growth factor, leukemia inhibitory factor,leukemia inhibitory factor receptor α, nerve growth factor nerve growthfactor receptor, neurotrophin-3, neurotrophin-4, placenta growth factor,placenta growth factor 2, platelet-derived endothelial cell growthfactor, platelet derived growth factor receptor α, platelet derivedgrowth factor receptor β, pre-B cell growth stimulating factor, stemcell factor, stem cell factor receptor, transforming growth factor βbinding protein I, transforming growth factor β binding protein II,transforming growth factor β binding protein III, tumor necrosis factorreceptor type I, tumor necrosis factor receptor type II, urokinase-typeplasminogen activator receptor, vascular endothelial growth factor, andchimeric proteins and biologically or immunologically active fragmentsthereof.

A “BPI inhibitor” as used herein includes any agent (except for heparinand heparin-like molecules [Khoury et al., Am. J. Physiol. Lung CellMol. Physiol., 279:L252-L261, 2000; Hu et al., Br. J. Exp. Pathol. 1989Apr; 70(2):113-24]) that inhibits the type of proliferation induced by aBPI protein product and thus includes agents capable of inhibiting theeffect or activity of a BPI protein product in enhancing pericyteproliferation, including antibodies that specifically bind to a BPIprotein product or a pericyte receptor that recognizes a BPI proteinproduct (including polyclonal antibodies, monoclonal antibodies,fragments thereof, chimeric antibodies, single chain antibodies,humanized antibodies, and human antibodies), antisense polynucleotides(which may bind e.g. to RNA or to DNA in triple helix formation), andcompounds (including small molecules) that inhibit theproliferation-promoting activity of BPI by inhibiting the activity of areceptor on pericytes that recognizes BPI protein products, e.g. byinhibiting binding to, interaction with, or signal transduction of thereceptor. The activity of a receptor can be inhibited by, e.g.,antibodies that specifically bind to the receptor, antisensepolynucleotides that inhibit expression of the receptor, molecules orpeptides that competitively inhibit binding of BPI protein products tothe receptor, or molecules that antagonize the receptor.

The invention also provides methods of screening for other BPI proteinproducts that enhance pericyte proliferation. Such methods wouldcomprise steps of, e.g., contacting pericytes with a BPI protein productand measuring growth or proliferation of the cells. Optionally thescreening methods involve a further step of testing selected candidatecompounds in in vitro models or animal models of pericyte proliferationknown in the art wherein the proliferation results in desirable effects.Animal models are not well defined for pericyte growth. Studiesperformed to date quantitate pericyte levels in young versus old animalsbut not in adult animals (vis a vis changes in pericyte levels). Invitro studies are usually conducted with pericyte co-culture models.Usually pericytes are cultured along with endothelial cells or smoothmuscle cells or are isolated and maintained as primary cultures fromlung, brain, retina or other tissue. See, e.g., Khoury et al., 1998,Microvasc. Res. 56:71; Verbeek et al., 1997, J. Neurochem., 68:1135;Doherty et al., 1998, J. Bone and Mineral Res., 13:828; Nehls et al.,1994, Microvasc. Res. 48: 349-363, D'Amore Semin Cancer Biol 3(2):49-56,1992, D'Amore, 1990, “Culture and Study of Pericytes” in Cell CultureTechniques in Heart & Vessel Research, Springer Verlag, New York, pages299-314. The screening methods may also involve a further step oftesting selected candidate compounds for ability to inhibit endothelialcell proliferation or angiogenesis in cell culture assays or animalmodels known in the art, e.g. those described in U.S. Pat. Nos.5,639,727, 5,807,818 and 5,837,678 and International Publication No. WO94/20128 (PCT/US94/02401), and in co-owned, co-pending U.S. Ser. No.09/602,811 filed Jun. 23, 2000 and corresponding InternationalPublication No. WO 01/00655 (PCT/US00/17358), all of which areincorporated by reference herein. BPI protein products, includingBPI-derived peptides, can be screened for proliferation-promotingactivity using these methods. In addition, the rational design ofmolecules that function like pericyte proliferation-enhancing BPIprotein products is contemplated. For example, peptides or other organicmolecules may be synthesized that mimic the structure and function ofBPI protein products with the desired pericyte proliferation-enhancingactivity.

Further provided are compounds identified by these screening methodsdescribed herein as well as methods of using these compounds fortreating conditions associated with, resulting from or exacerbated bypericyte degeneration.

The invention further provides methods of screening organic or inorganiccompounds for the ability to inhibit proliferation induced by BPIprotein products. Suitable standards for use in such screening assaysinclude any BPI protein product that enhances pericyte proliferation,e.g., rBPI₂₁ or XMP.679. Such methods would comprise steps of, e.g.,contacting pericytes with a BPI protein product and a candidatecompound, and measuring growth or proliferation of the cells in thepresence and absence of the test compound. Optionally, as a control, thegrowth or proliferation of the pericytes is also measured in thepresence and absence of the test compound alone (in the absence of BPIprotein product). The screening methods may involve a further step oftesting selected candidate compounds in in vitro models or animal modelsof pericyte proliferation known in the art wherein the proliferationresults in deleterious effects. See, e.g., D'Amore, “Culture and Studyof Pericytes” in Cell Culture Techniques in Heart & Vessel Research,Springer Verlag, New York, pages 299-314 (1990).

Pericyte assays are preferably conducted using primary cultures ofbovine retinal pericytes as described in Example 2.

Alternatively, the receptor present on the surface of pericytes can beidentified by, e.g., immunoaffinity purification using a BPI proteinproduct and this receptor can be used in an initial screen to identifychemical compounds that bind the receptor.

These methods according to the invention can be used for high throughputscreening of libraries of molecules, such as inorganic or organiccompounds (including bacterial, fungal, mammalian, insect or plantproducts, peptides, peptidomimetics and/or organomimetics).

Further provided are compounds identified by these screening methods aswell as methods of using these compounds for treating in conditionsassociated with, resulting from or exacerbated by pericyteproliferation.

Sources for test compounds to be screened include (1) inorganic ororganic chemical libraries, (2) natural product libraries, or (3)combinatorial libraries comprised of either random or mimetic peptides,oligonucleotides or organic molecules. Chemical libraries may be readilysynthesized or purchased from a number of commercial sources, and mayinclude structural analogs of known compounds or compounds that areidentified as “hits” or “leads” via natural product screening. Thesources of natural product libraries are collections of microorganisms(including bacteria or fungi), animals, plants or other vegetation, ormarine organisms, and libraries of mixtures for screening may be createdby: (1) fermentation and extraction of broths from soil, plant or marinemicroorganisms or (2) extraction of the organisms themselves. Naturalproduct libraries include polyketides, non-ribosomal peptides, and/orvariants (non-naturally occurring) variants thereof. For a review, seeScience 282:63-68 (1998). Combinatorial libraries are composed of largenumbers of peptides, oligonucleotides or organic compounds and can bereadily prepared by traditional automated synthesis methods, PCR,cloning or proprietary synthetic methods. Of particular interest arepeptide or oligonucleotide combinatorial libraries. Still otherlibraries of interest include peptide, protein, peptidomimetic,multiparallel synthetic collection, recombinatorial, or polypeptidelibraries. For a review of combinatorial chemistry and libraries createdtherefrom, see Myers, Curr. Opin. Biotechnol. 8:701-707 (1997). Forreviews and examples of peptidomimetic libraries, see Al-Obeidi et al.,Mol. Biotechnol, 9(3):205-23 (1998); Hruby et al., Curr Opin Chem Biol,1(1): 114-19 (1997); Dorner et al., Bioorg Med Chem, 4(5):709-15 (1996)(alkylated dipeptides). A variety of companies have constructed chemicallibraries and provide their use for screening, including for example,3-Dimensional Pharmaceuticals, Exton, Pa.; Agouron Pharmaceutical, LaJolla, Calif.; Alanex Corp., San Diego, Calif.; Ariad Pharmaceuticals,Cambridge, Mass.; ArQule, Inc., Medford, Mass.; Arris Pharmaceutical, S.San Francisco, Calif.; Axys, S. San Francisco, Calif.; BiocrystPharmaceuticals, Birmingham, Ala.; Cadus Pharmaceuticals, Tarrytown,N.Y.; Cambridge Combinatorial, Cambridge, UK; ChemGenics, Cambridge,Mass.; CombiChem, San Diego, Calif.; Corvas International, San Diego,Calif.; Cubist Pharmaceuticals, Cambridge, Mass.; Darwin Molecular,Bothell, Wash; Houghten Pharmaceuticals, San Diego, Calif.; Hybridon,Cambridge, Mass.; Isis Pharmaceuticals, Carlsbad, Calif.; Ixsys, SanDiego, Calif.; Molecumetics, Bellevue, Wash.; Peptide Therapeutics,Cambridge, UK; Pharmacopia, Princeton, N.J.; SUGEN, Redwood City,Calif.; Telik, Inc., S. San Francisco, Calif.; or Tripos, Inc., St.Louis, Mo.

Example 1 describes the effect of BPI protein products on bovine retinalendothelial cells. Example 2 describes the effect of BPI proteinproducts on primary cell cultures of bovine retinal pericytes and on acell line of human retinal pericytes, as well as on MAP kinasephosphorylation. Example 3 describes the effect of BPI protein productson bovine retinal pigment epithelial cells. Example 4 describes studieswith BPI protein products in a variety of animal models, including aneonatal mouse model of retinal neovascularization.

EXAMPLE 1 Effect on Bovine Retinal Capillary Endothelial Cells

Primary cultures of bovine retinal endothelial cells (BREC) wereisolated by homogenization and a series of filtration steps as describedin King et al., J. Clin. Invest., 1985, 75:1028-36. BREC weresubsequently cultured with endothelial cell basal medium (EBM;Clonetics, San Diego, Calif.). supplemented with 10% plasma-derivedhorse serum (PDHS), 50 mg/l heparin, and 50 μg/ml endothelial cellgrowth factor (ECGF, Roche, Indianapolis, Ind.). Cells werecharacterized for homogeneity by their immunoreactivity with anti-factorVIII antibody. Cells remained morphologically unchanged under theseconditions, as confirmed by light microscopy. Only cells from passages 2through 7 were used for the experiments.

A cell growth assay was performed as follows: Cells were plated onto12-well culture plates and incubated overnight. The cells were treatedwith vehicle, vascular endothelial growth factor (VEGF, R & D Systems,Minneapolis, Minn.) at 25 ng/ml, serum, compounds, or combinationsthereof. The medium is changed during the incubation period, with freshmedium and fresh test compound added every 2 days. After incubation forindicated time period at 37° C., the cells were lysed in 0.1% SDS andDNA content was measured by means of Hoechst-33258 dye and a fluorometer(model TKO-100, Hoefer Scientific Instruments, San Francisco, Calif.).It has been shown that total cellular DNA content measured in thismanner correlates closely with actual cell number as determined byhemocytometer counting of trypsinized cells.

Determinations were performed in triplicate and all experiments wererepeated at least three times. Results are expressed as themean±standard deviation, unless otherwise indicated. Statisticalanalysis employed Student's t-test or analysis of variance to comparequantitative data populations with normal distributions and equalvariance. Data were analyzed using the Mann-Whitney rank sum test or theKruskal-Wallis test for populations with non-normal distributions orunequal variance. A P-value of <0.05 was considered statisticallysignificant.

No differences were observed in growth between vehicle treated andnon-treated cells with regard to total DNA content. rBPI₂₁ alone(without addition of VEGF) at 25 or 75 μg/ml also did not have asignificant effect. However, the addition of VEGF at 25 ng/ml increasedsignificantly the amount of DNA content by 3 to 5 fold (p<0.01). Theaddition of VEGF and either vehicle or 25 μg/ml of rBPI₂₁ did not have asignificant effect. In contrast, the addition of VEGF and 75 μg/ml ofrBPI₂₁ decreased significantly the DNA content (p<0.05), indicating thatrBPI₂₁ was able to inhibit VEGF-dependent growth of bovine retinalcapillary endothelial (BREC) cells at a concentration of 75 μg/ml.

Results showed that XMP.679 appears to have a slight growth inhibitoryeffect itself against BREC at 15 μg/ml, although this effect was notstatistically significant. Again, the addition of VEGF alone at 25 ng/mlincreased DNA content by 3 to 4 fold. The addition of VEGF and XMP.679at 1 μg/ml had no effect, but the addition of VEGF and XMP.679 at 5 and15 μg/ml totally prevented VEGF-dependent growth of BREC.

In additional experiments, cell growth assays as described above wereconducted with 25 or 75 μg/ml rBPI₂₁ or 5 or 15 μg/ml XMP.679 (with andwithout addition of 25 ng/ml VEGF) and similar results were observed.The addition of VEGF and 25 μg/ml rBPI₂₁ again did not have asignificant effect on DNA content. However, the addition of VEGF and 75μg/ml rBPI₂₁ again prevented VEGF-dependent growth of BREC. Likewise theaddition of VEGF and 5 or 15 μg/ml XMP.679 again preventedVEGF-dependent growth of BREC. Experiments with lower concentrations ofBPI protein products (5 μg/ml rBPI₂₁ or 1 μg/ml XMP.679), with andwithout the addition of VEGF, did not have a significant effect on DNAcontent. These experiments demonstrate that exemplary protein productsrBPI₂₁ or XMP.679 inhibit VEGF-dependent growth of bovine retinalcapillary endothelial cells.

EXAMPLE 2 A. Effect on Bovine Retinal Pericyte Cells

Primary cultures of bovine retinal pericytes (BRPC) were isolated byhomogenization and a series of filtration steps as described in King etal., J. Clin. Invest., 1985, 75:1028-36. BRPC were cultured inDulbecco's modified Eagle's medium (DMEM, Gibco BRL, Grand Island, N.Y.)with 5.5 mM glucose and 20% fetal bovine serum (FBS, Gibco BRL, GrandIsland, N.Y.). Cells were characterized for homogeneity by theirimmunoreactivity with monoclonal antibody 3G5 [Nayak et al., J. Exp.Med. 1988, 167:1003-15]. Cells remained morphologically unchanged underthese conditions, as confirmed by light microscopy. Only cells frompassages 2 through 7 were used for the experiments.

A cell growth assay was performed as described above in Example 1 andthe medium was changed, with fresh medium and fresh test compound addedevery 2 or 3 days, preferably every 2 days. At 5% FBS, DNA content didnot change after six days. At 20% FBS a six to seven fold increase oftotal DNA was detected.

The addition of rBPI₂₁ at 5, 25, 75 μg/ml in the presence of 5% FBSincreased DNA content in a dose responsive manner. At 75 μg/ml, a 5 foldincrease of DNA above basal level was noted. XMP.679 at 1 or 5 μg/mlincreased growth at 6 days, whereas 15 μg/ml of XMP.679 did not increasegrowth of the pericytes at either 3 or 6 days above basal which wassimilar to the effect of 5% FBS. Results are depicted in FIGS. 1A(rBPI₂₁) and 1B (XMP.679).

These results indicate that rBPI₂₁ enhanced growth of retinal pericytesin a dose responsive manner with a maximum observed at 75 μg/ml thatalmost equaled the growth effect of 20% FBS. XMP.679 was able toincrease growth at 5 μg/ml, which reached about 30 to 40% the potency of20% FBS. At a higher concentration, XMP.679 did not show a growthstimulating effect.

The experiment was repeated in combination with 10% FBS. Again, similarfindings were observed. Addition of rBPI₂₁ induced the growth ofpericyte at 10% FBS at concentrations of 5, 25 and 75 μg/ml.Interestingly, 25 and 75 μg/ml of rBPI₂₁ appeared to improve growthabove that of 20% FBS. XMP.679 at 5 μg/ml equaled the effect of 20% FBS,whereas 15 μg/ml did not have much growth effect. These resultsindicated that, at 10% FBS, rBPI₂₁ may have more growth effect than 20%FBS. This is quite unusual, since not many growth factors can improvethe growth effects of 20% FBS in enhancing the growth of retinalpericytes.

The experiment was repeated with 15% FBS, which can stimulate pericytegrowth by approximately 6-8 fold after six days of incubation. Again,20% FBS was more potent as well as reaching a higher level of growthafter 6 days then 15%. The addition of 75 μg/ml rBPI₂₁ increased thegrowth greater then 20% FBS. In comparison, the addition of XMP.679 didnot increase the growth of pericyte in 15% FBS to any significantamount. These results indicated that even at 15% FBS, rBPI₂₁ was able tostimulate more growth then either 15 or 20% FBS. The effect of XMP.679was less than that of rBPI₂₁. There is a trend that, at 5 μg/ml ofXMP.679, it may have more growth effect than either 15 or 20% FBS.

The conclusion from these data is that rBPI₂₁ and, to a lesser extent,XMP.679, enhanced proliferation of retinal pericytes. This enhancedgrowth was dose-dependent, with rBPI₂₁ at 75 μg/mL resulting in a 3-foldstimulation (there was no net growth in the controls). XMP.679 showedperhaps a 2-fold stimulation at 5 μg/mL, but no enhancement at 15 μg/mL.This observation was reproducible and occurred in 5, 10 or 15% FBS.

In additional experiments, both the DNA content and total cell numberper well were determined in BRPC treated with 5, 25, 75 μg/ml rBPI₂₁ inthe presence of 5% FBS. The addition of rBPI₂₁ at 5, 25, 75 μg/ml in thepresence of 5% FBS again increased DNA content in a dose responsivemanner. Similarly, the total number of cells per well also increased ina dose responsive manner. These observations indicate that the rBPI₂₁induced dose dependent increase in DNA content correlates with therBPI₂₁ induced dose dependent increase in proliferation of bovineretinal pericytes.

Growth assays were also repeated with 1, 5, 15 μg/ml XMP.679 and withadditional concentrations of 10 or 20 μg/ml XMP.679 at 10% FBS.Statistically significant increases in pericyte DNA content weremeasured at 1, 5, 10, and 15 μg/ml XMP.679. Similar results as abovewere observed with 5 μg/ml XMP.679 again showing the greatest increasein retinal pericyte proliferation, while a higher concentration ofXMP.679 (20 μg/ml) did not.

Experiments were also performed in which the level of MAP kinasephosphorylation was determined in BRPC treated with 75 μg/ml rBPI₂₁ or 5μg/ml XMP.679. The level of MAP kinase phosphorylation was determined 1,3, 5, 15, 30 and 60 minutes after the addition of rBPI₂₁ or XMP.679.rBPI₂₁ increased MAP kinase phosphorylation over time with a maximumphosphorylation 15 minutes after the addition of rBPI₂₁ that nearlyequaled the effect of 20% FBS. XMP.679 increased MAP kinasephosphorylation over time with a maximum phosphorylation between 15 and60 minutes. These observations indicate that exemplary BPI proteinproducts rBPI₂₁ and, to a lesser extent, XMP.679, enhance MAP kinasephosphorylation in BRPC. Moreover, these results suggest that the BRPCMAP kinase phosphorylation is useful for the screening of othercompounds for this stimulatory activity.

B. Effect on Human Retinal Pericyte Cells

In addition to studies with primary cell cultures of bovine retinalpericytes described above, experiments were performed with a human cellline obtained from Clonetics (San Diego, Calif.) of retinal pericytes(catalog no. CC-2542 PyCRt). These human retinal pericytes (HRPC) werecultured in Dulbecco' s modified Eagle's medium (DMEM, Gibco BRL, GrandIsland, N.Y.) with 5.6 mM glucose and 20% fetal bovine serum (FBS, GibcoBRL, Grand Island, N.Y.).

Proliferation assays were performed as follows: HRPC were plated onto24-well culture plates (3000 cells/well) in 5 or 10% FBS-DMEM with 5.6mM glucose and incubated overnight. The cells were treated once withvehicle alone or with vehicle and several concentrations of XMP.627([SEQ ID NO: 4]), XMP.664 ([SEQ ID NO: 5]), XMP.679 ([SEQ ID NO: 3]), orXMP.728 ([SEQ ID NO: 6]) for 5 or 6 days. The medium was not changed,nor were additional amounts of test compounds added as described in theexperiments of part A above. The cells were fixed and stained withMethylene blue and proliferation assayed by observation at OD₆₅₀.

The addition of XMP.679 at approximately 0.5, 1, 5, 8 μg/ml in thepresence of 5% FBS increased HRPC proliferation in a dose responsivemanner, with a maximum observed at approximately 5 μg/ml. Results showedthat XMP.679 at concentrations of 10 μ/ml and higher appeared to have aslight growth inhibitory effect itself against HRPC. When the experimentwas repeated in the presence of 10% FBS, similar findings were observed.

The addition of XMP.664 at approximately 0.5, 1, 5 μg/ml similarlyincreased HRPC proliferation in a dose responsive manner in the presenceof 5% FBS, with a maximum observed at approximately 5 μg/ml. Resultsshowed that XMP.664 at concentrations of 10 μg/ml and above XMP.664appears to have a slight growth inhibitory effect against HRPC. When theexperiment was repeated in the presence of 10% FBS, results showed 10μg/ml XMP.664 increased HRPC proliferation, while XMP.664 above 10 μg/mlinhibited proliferation.

The addition of XMP.627 at approximately 0.5, 1, 5, 8 μg/ml in thepresence of 5% FBS increased HRPC proliferation in a dose responsivemanner, with a maximum observed at approximately 5 μg/ml. XMP.627appears to have a slight growth inhibitory effect itself against HRPCabove 10 μg/ml. The addition of XMP.627 in the presence of 10% FBS didincrease HRPC proliferation.

The addition of XMP.728 similarly increased HRPC proliferation at onlyat approximately 5 μg/ml in the presence of 5% FBS, and to lesser extentin the presence of 10% FBS.

These results indicate that XMP.679 enhanced proliferation of HRPC witha maximum observed at approximately 5 μg /ml. Similarly, additionalexemplary BPI protein products XMP. 627, XMP. 664, and XMP.728 showedsimilar HRPC stimulatory activity.

In an initial experiment with rBPI₂₁ with HRPC, and in contrast to theresults with primary cell cultures of bovine retinal pericytes describedin part A above, little or no proliferation was observed. Similarresults were obtained in an initial experiment with rBPI₅₀, rBPI₄₂, andfusion proteins such as a BPI-Ig fusion (e.g., rBPI₂₃-Ig) or a BPI-LBPfusion (e.g. P4161 as described in Abrahamson et al., Journal ofBiological Chemistry, 272: 2149-2155 (1997),) as well as XMP.711 ([SEQID NO: 7]), XMP.852 ([SEQ ID NO: 8]), and XMP.861 ([SEQ ID NO: 9]).XMP.718 ([SEQ ID NO: 10]) and XMP.365 ([SEQ ID NO: 11]) appeared toexhibit some toxicities on HRPC in an initial assay. In contrast,XMP.629 ([SEQ ID NO: 12), XMP.676([SEQ ID NO: 13]), XMP.768 ([SEQ ID NO:14]), and XMP.851 ([SEQ ID NO: 15]), enhanced the proliferation of HRPC.Additional assays are conducted with BPI protein products, wherein thecell culture medium is changed and additional amounts of test compoundis added as described in the experiments of part A above, and theenhancement of proliferation of HRPC is measured as described above.

EXAMPLE 3 Effect on Bovine Retinal Pigment Epithelial Cells

Bovine retinal pigment epithelial cells (RPEC) were isolated by gentlescraping after removal of the neural retina and incubation with 0.2%collagenase as described in King et al., Diabetes, 1987, 36:1460-7. RPECwere cultured in DMEM with 5.5 mM glucose and 10% calf serum (CS, GibcoBRL, Grand Island, N.Y.). Cells were cultured in 5% CO₂ at 37° C., andmedia were changed every other days. Cells were characterized for theirhomogeneity by immunoreactivity with anti-cytokeratin antibody for RPEC.Cells remained morphologically unchanged under these conditions, asconfirmed by light microscopy. Only cells from passages 2 through 7 wereused for the experiments.

A cell growth assay was performed as described above in Example 1.Results are shown in FIG. 2. The addition of rBPI₂₁ had no effect at 75μg/ml. XMP.679 had some (approximately 20 to 30%) growth promotingeffect at 15 μg/ml.

EXAMPLE 4 In Vivo Effects of BPI Protein Products A. In Vivo Assay forAnti-Angiogenesis Effect In Neonatal Mice

To produce ischemia-induced retinal neovascularization, litters of7-day-old (postnatal day 7, P7) C57BL/6J mice and their nursing motherswere exposed to 75±2% oxygen for 5 days and then returned to ambient airat age P12 as described in Smith et al., Invest. Ophthalmol. Vis. Sci.,1994, 35:101-111. Intraperitoneal injections of XMP.679 (10 mg/kg) wereperformed every 24 hrs from P12 to P17. Control animals received saline.After sacrifice and enucleation, flat-mounted, fluorescein-conjugateddextran-perfused retinas were examined to assess the retinalvasculature.

This mouse model reflects the effects of hypoxia on inducingangiogenesis in the retina. After birth, the mice are exposed to a highlevel oxygen for 4-5 days. The effect of high levels of oxygen willdecrease or prevent the growth of blood vessels in the retina. Once themice have been removed from the hyperoxic condition to normal oxygenlevels, the retina will develop hypoxia due to the lack of bloodvessels. The hypoxia in the retina will induce many growth factors(including VEGF) which leads to a angiogenic response that can bequantitated by measuring the number of nuclei in the blood vessels abovethe internal limiting membrane. This mouse model of angiogenesis isthought to be a good animal reflection of retinopathy of prematurity.The main growth factor responsible for retinal angiogenesis in thismouse model is thought to be due to the expression of VEGF.

As in previous studies, examination of the flat-mounted,fluorescein-conjugated dextran-perfused retinas and hematoxylin-eosinstained sections of tissue obtained after 5 days of hypoxia from controlanimals showed neovascular rufts, particularly in the mid-periphery,extending above the internal limiting membrane into the vitreous. Theseneovascular rufts were most prominent on P17-19, but after P23 theneovascularization regressed, and the vascular pattern normalized byP26.

As described in Aiello et al., Proc. Nat'l Acad. Sci. USA, 1995,92:10457-61, mice at P17 (n=5) were deeply anesthetized withpentobarbitol sodium (100 mg/kg) and sacrificed by cardiac perfusionwith 4% paraformaldehyde in phosphate-buffered saline. Eyes wereenucleated and fixed in 4% paraformaldehyde at 4° C. overnight, andenbedded in paraffin. Over 50 serial sections (6 μm) including opticnerve head were placed on microscope slides. After staining withperiodic acid/Schiff reagent and hematoxylin, 10 intact sections ofequal length, each 30 μm apart, were evaluated for a span of 300 μm. Allretinal vascular cell nuclei anterior to the internal limiting membranewere counted in each section by a fully masked protocol. The mean of all10 counted sections yielded average neovascular cell nuclei per 6 μmsection per eye. No vascular cell nuclei anterior to the internallimiting membrane are observed in normal unmanipulated animals.

The retina of mice given XMP.679 via daily intraperitoneal injectionsshowed fewer blood vessels with much less density and tortuosity thenthose observed in control mice. XMP.679 also reduced the number ofnuclei above the internal limiting membrane and decreased the number ofnuclei anterior to the internal limiting membrane (p<0.001) byapproximately 30 to 40%.

In addition to the experiments with 10 mg/kg XMP.679 as described above,experiments with 20 mg/kg XMP.679 were performed. Similar findings wereobserved. The retina of mice (n=6) given 20 mg/kg XMP.679 via dailyintraperitoneal injections showed reduced number of nuclei above theinternal limiting membrane and decreased the number of nuclei anteriorto the internal limiting membrane (p<0.01) by approximately 71%. Theseresults indicate that an exemplary BPI protein product XMP.679 inhibitsretinal neovascularization in a dose responsive manner (e.g., in therange of 10-20 mg/kg) in neonatal mice.

B. In Vivo Assay for Anti-Angiolgenesis Effect In Rats

In contrast to the assay for anti-angiogenesis effect of BPI proteinproducts in neonatal mice described in part A above, experiments wereconducted in newborn rats Crj:CD(SD)IGS (Charles River, Japan). Unlikethe method described in part A above of producing ischemia-inducedretinal neovascularization by exposing neonatal mice to a constant levelof oxygen at 75±2% for 5 days, newborn rats were exposed to oxygenpulses as described below.

The newborn rats within a few hours after birth were put into the oxygenchamber (780 mm×520 mm×520 mm). The oxygen level in the experimentalchamber was controlled with a computer program (Oxycycler, RemingBioinstruments, NY, US). The oxygen level was maintained at 80% for 20.5hours, then rapidly dropped to 21% for 30 minutes before a gradualreturn to 80% during the following 3 hours. The program was run for 11cycles (24 hour per cycle). At the end of 11^(th) cycle (postnatal day11 (P11)), mothers and newborn rats were transferred to room aircondition and kept for 7 days. For a seven day period step newborn ratswere injected intraperitoneally with XMP.679 at doses of 2, 6 and 20mg/kg. On P18, the rats were sacrificed, and the left eyes wereenucleated. The eyes were fixed in 4% paraformaldehyde (PFA) for 1 hour.Using scissors, the cornea and sclera were removed from the eyecup. Thelens was removed with tweezers, and the vitreous was thoroughly removedwith tweezers and scissors. The semi-spherical retina was fixed in 4%PFA and stained, using the method of adenosine diphosphatase (ADPase)histochemistry. Abnormal neovascularization was assessed on P18 byhistochemically staining retina for ADPase activity. This procedurepreferentially stains retinal vascular endothelium and microglia in ratsof this age. The retina was incubated in ADPase incubation medium at 37°C. for 1 hour with gentle agitation. It was then washed thoroughly incold saline, and treated in a 1:10 dilution of ammonium sulfide for 1minute. The retina was then washed in silane to remove sulfide. Theretina was placed in a small drop of liquid on a saline-coated slide.Release the curve of the retina with 4 radial cut to define superior,inferior, nasal and temporal quadrants. The retina was put in a layer ofPerma Fluor® covered with a cover glass. Glomerular buds (tiny popcorn)upon the surface of the regina, fan shaped neovascular fronds, andridges (vascular complexes that cause a distinct elongate elevation ofthe retinal surface, and which usually contain several vessels runningparallel to the ciliary body) were identified.

Criteria for scoring neovascular intensity were as follows: 0: Nothing;1:<5 buds; 2:>5 buds, or a frond; 3: Ridge<half of quadrant; or 4:Ridge>half of quadrant. The retinal neovascular scores were equal to thesum of quadrant scores. These scores were 6.41 in vehicle-injected eyes,and 7.29, 4.59 and 5.56 in the eyes of XMP.679 injected rats (2, 6 and20 mg/kg/day, respectively). Although the differences were notstatistically significant, the retinal neovascularization score wasreduced by XMP.679 at 6 mg/kg.

C. In Vivo Studies in Hypergalactosemic Rats

Additional in vivo studies are carried out with test compounds,including BPI protein products, either in hypergalactosemic rats [Kernand Engermann, 1995, Arch. Ophthalmol., 114(8):986-990] or in transgenicmice overexpressing PKC β isoform in the blood vessels with theinduction of diabetes by STZ [Robison et al., Curr. Exp. Res. 10:338(1991)]. [Ruggiero et al., 1997 Diabetes & Metabolism 23:30-42; Hirschi& D'Amore, Cardiovasc Res 1996 Oct;32(4):687-98.]

D. Studies of Choroidal Neovascularization Membrane Formation in LaserTreated Rats.

The effect of test compounds, including BPI protein products, in anage-related model of macular degeneration are also studied in a primatemodel [Monaco & Wormington Optom Vis Sci 1990 Jul;67(7):532-7; Hope etal., Br J Ophthalmol. 1992 Jan;76(1):11-6]. Additionally, to demonstratethe use of test compounds, including BPI protein products, as a therapyfor the wet form of age related-macular degeneration, their effects onchoroidal neovascular membrane (CNVM) formation in laser treated ratsare studied. Assays are performed as follows.

Adult male Brown Norway rats (Harlan Sprague Dawley, Inc., Indianapolis,Ind.) are anesthetized (75 mg/kg ketamine, 2.5 mg/kg acepromazine, and0.05 mg/kg atropine to minimize bronchial secretions) and undergopupillary dilation (topical cyclopentolate 1%, phenylephrine 2.5%, andatropine sulfate 1%). The animals are positioned on a Mayo stand and thefundus is visualized using a microscope slide cover slip and goniosol asa contact lens. Eight Krypton red photocoagulation burns (150 mW, 199uM, 00.5 sec) are applied in the funds at equal distances surroundingthe optic disk. This intensity produced ruptures in Bruch's membranewith reproducible CNVM formation and minimal collateral damage to themid and inner retina. Providone 5% is applied to the ocular surface, anda topical anesthesia ( 0.5% propoparacaine hydrochloride) is appliedprior to an intravitreal injection. Immediately (within ˜5 minutes)after placement of the laser photocoagulation burns, animals receive asingle intravitreal injection of a test compound, including a BPIprotein product, in one eye, and the control vehicle is injected intothe contralateral eye. Groups of animals receive different dosage oftest compound, such as a BPI protein product—for example, byintraperitoneal or intravitreal administration. Another group receivesno intravitreal injections and serve as laser-only controls.

At 14 days post-treatment one half of the animals from each dosage groupundergo fundus photography, fluorescein angiography, and histopathologyof retrieved eyes, to assess neovascularization. At 28 dayspost-treatment the remaining animals from each dosage group, as well aslaser-only controls, undergo neovascularization assessment.

Fundus color photography is used determine the size of the laser burn,as well as the presence of subretinal vessels, subretinal hemorrhage,and subretinal fluid. CNVM are graded on a fluorescein angiogramclassification scheme [Reinke et al, Invest. Ophthalmology Vis Sci(Suppl) 1996; 37, 125] Fluorescein angiogram findings are correlatedwith those from histopathology. For histophathogy, the eyes areenucleated and eyecup preparations fixed overnight at room temperaturewith in 4% phosphate-buffered paraformaldehyde. Tissue sections aredehydrated, embedded in paraffin, 6um sectioned are stained withhematoxylin and eosin for light microscopy. Histologic specimens areexamined by light microscopy for presence or absence ofneovascularization; the level of neovascularization with respect to thechoroid, Bruch' s membrane, or the retina; the response or the RPE cellsto original injury and subsequent CNVM. Additionally, ocular toxicologyof test compounds, including BPI protein products, on the eye isclinically evaluated and graded, and the tissue and cellularcharacteristics are evaluated histopathologically.

E. In Vivo Anti-Permeability Studies

1.) Effects on VEGF-induced Retinal Vascular Permeability.

The effects of a test compound, including a BPI protein product, onVEGF-induced vascular permeability in an in vivo rat model is determinedby vitreous flourophotometry as described in Aiello et al., Diabetes1997; 40:1473-1480. Assays are performed as follows.

Adult male Sprague-Dawley rats are treated, for example, by intravitrealor intraperitoneal administration of test compounds, such as BPI proteinproducts, or vehicle alone. A catheter is implanted into the rightjugular vein 24 hrs prior to vitreous flourophotometry. Baselinevitreous fluorescence measurements are obtained from all animals tocorrect for intrinsic fluorescence and subtracted from all subsequentvitreous fluorescence measurements. VEGF (2 ng eye, 25 ng/ml final) isinjected intraocularly at time 0 into one eye and bovine serum albumin(BSA)/saline control is administered to contralateral eye. Fifteenminutes later, 30-65 pt of 10% sodium fluorescein is (Akom, AbitaSprings, Calif.) is injected into through the jugular catheter. Vitreousfluorescein leakage is measured by fluorphotomotry 40 minutes afterbaseline vitreous fluorescence measurements are made. The accumulationof fluorescein dye in the vitreous of the eye is measured by utilizingthe fluorescein excitation wavelength of 488 nm and integrating theresulting fluorescence centered at the fluorescence peak (520 nm) fromthe center of the vitreous.

2.) Effects on Diabetes-induced Retinal Vascular Permeability.

The effect of test compounds, including BPI protein products, ondiabetes induced-retinal vascular permeability is studied in rats asdetermined by Evans-Blue diffusion as described in Xu et al., Invest.Opthalmol Vis. Sci. 2001;42:789-794. Evans-Blue dye binds to plasmaalbumin and diffuses into the surrounding tissue over a fixed period oftime. The concentration of dye is measured by extracting it from thetarget tissue and quantifying it by spectrophotometry. The amount ofalbumin-bound dye in retinal tissue correlates with retinal vascularpermeability. Assays are performed as follows.

Sprague-Dawley rats are made diabetic using Streptozotocin and diabeticconfirmed by blood glucose measurements after 24 hours. Animals aretreated for example, with intraperitoneal or intravitreal administrationof test compounds such as BPI protein products or vehicle alone. Apolyvinyl catheter (Braintree Scientific, Braintree, Mass.) is implantedinto the right jugular vein of anesthetized rats 24 hrs prior tomeasurements of Evans-Blue dye. On the day of the experiment, Evans-Bluedye (45 g/kg) is injected into the jugular catheter. Two hours after thedye injection, additional anesthesia is given and a laparotomy isperformed to expose the descending vena cava. Heparinized venous blood(0.9 cc) is withdrawn to determine the average plasma dye concentration.The chest cavity is exposed and a 25-gauge butterfly catheter isinserted into the left ventricle. The arch of the vena cava is cut and30 cc of saline is infused into the heart at physiological pressurethrough the butterfly catheter. After saline infusion, 30 cc of 10%Formalin is infuse to fix the tissues. Following tissue fixation, theeyes are nucleated. The retina from each eye is isolated using asurgical microscope and placed in pre-weighed ependorf tube. The retinasamples are incubated in formamide overnight at 72° C. to extract theEvans-Blue dye. Following incubation, the resulting extract isultra-centrifuged and the supernatent used for spectrophotometricmeasurements. Absorbance is measured at 620 nm (Evans-Blue maximum) and720 nm (Evans-Blue minimum).

Numerous modifications and variations of the above-described inventionare expected to occur to those of skill in the art. Accordingly, onlysuch limitations as appear in the appended claims should be placedthereon.

1. A method of enhancing pericyte cell proliferation comprisingadministering to a subject in need thereof an amount of a BPI proteinproduct effective to enhance proliferation of pericyte cells. 2-4.(canceled)
 5. The method of claim 1 wherein the subject is sufferingfrom age related macular degeneration (ARMD). 6-19. (canceled)
 20. Themethod of claim 1 wherein the BPI protein product is an amino-terminalfragment of BPI protein having a molecular weight of about 20 kD to 25kD, or a dimeric form thereof.
 21. The method of claim 1 wherein the BPIprotein product is a BPI-derived peptide.
 22. The method of claim 21wherein the BPI-derived peptide is XMP.679. 23-34. (canceled)
 35. Amethod of enhancing pericyte proliferation in a subject suffering from apericyte degeneration disorder that is age related macular degeneration(ARMD), comprising administering to the subject an amount of a BPIprotein product effective to enhance proliferation of pericytes. 36-39.(canceled)